Core Platforms: A Modular Approach

A “Rip-and-Replace” or Full System Replacement is Not Always Necessary When Your Technology Needs Updating

The core platforms available to health plans are constantly evolving and improving progress. In this ever-changing space, it is vital for payers to make sure they are getting more value from their solutions. One of the dilemmas payers face today is whether to invest in a new platform or renovate/enhance their current platform.

If you determine your current technology solution is no longer meeting your demands, many vendors will offer full system replacements. This is often referred to as a “rip-and-replace” – and for many years this was the only feasible option.

However, with the advent of new modular solutions, “rip-and-replace” is not always necessary.  If one aspect of your technology is suboptimal (i.e., claims module), that singular module can be replaced and a new solution can be easily integrated into your technology stack.

The benefits of the modular approach include:

• Less expensive and disruptive

• Lower need for change management

• Less training

• More effective

• Focus on the root cause

• Less risky

Watch this video short to learn about “rip and replace” versus modular implementation:

Assessing the Need for New Technology

Some key aspects to consider in evaluating a system include:

• System Functionality

  • Technology needs to drive business value. Technology needs to augment the payer’s core competency.

• Cost and Value

  • Deciding whether to make the investment for a new software solution or to upgrade the current solution boils down to the question: “Am I getting more value out of the solution than I currently pay?” If the answer is no, a change could be merited.

• Vendor Relationships

  • Having the right vendor – a vendor committed to your success is a critical consideration. If a plan’s current vendor is not a good partner, it might be time to find a new vendor.

• Internal IT Capabilities

  • Many plans struggle to staff their IT department, either from a talent perspective or a cost perspective. A vendor with a solution that minimizes constraints on the payer’s IT department might create the case to explore a new technology solution.

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